Peng Wei-Chen, Chang Yi-Ping, Chao Yuan-Hung, Fu S N, Rolf Christer, Shih Tiffany Tf, Su Sheng-Chu, Wang Hsing-Kuo
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
Clin Biomech (Bristol). 2017 Mar;43:50-57. doi: 10.1016/j.clinbiomech.2017.02.002. Epub 2017 Feb 8.
BACKGROUND: Functional deficits are found in ankles that have sustained an Achilles rupture. This study sought to evaluate and compare the morphomechanical characteristics of the medial gastrocnemius muscle in the legs of participants within six months of a unilateral Achilles repair to determine any correlations between those characteristics and objective outcomes and self-reported functional levels. METHODS: Fifteen participants were assessed via measurements of muscle morphologies (fascicle length, pennation angle, and muscle thickness) in a resting state, the mechanical properties of the proximal aponeurosis of the medial gastrocnemius muscle, the pennation angle during ramping maximal voluntary isometric contractions (MVIC), the heel raise test, and the Taiwan Chinese version of the Lower Extremity Functional Scale (LEFS-TC) questionnaire. Findings Compared with the non-injured legs, the repaired legs showed a lower muscle fascicle length (mean 4.4 vs. 5.0cm) and thickness (1.7 vs. 1.9cm), lower stiffness of the GM tendon and aponeurosis (174.1 vs. 375.6N/mm), and a greater GM pennation angle (31.2 vs. 28.9°) during 90% MVIC (all p≤0.05). Correlations were found between the morphomechanical results and maximal heel raise heights or the LEFS-TC score, and between the symmetry ratios of the fascicle lengths and the LEFS-TC score. Interpretation There are decreases in fascicle length, muscle thickness and mechanical properties in the medial gastrocnemius muscles of the participants within the first six months after an Achilles repair. These morphomechanical alterations demonstrate associations with functional levels in the lower extremities and indicated the need for early mobilization of the calf muscles after the repair.
背景:在经历过跟腱断裂的踝关节中发现了功能缺陷。本研究旨在评估和比较单侧跟腱修复术后六个月内参与者腿部内侧腓肠肌的形态力学特征,以确定这些特征与客观结果和自我报告的功能水平之间的任何相关性。 方法:通过测量静息状态下的肌肉形态(肌束长度、羽状角和肌肉厚度)、内侧腓肠肌近端腱膜的力学性能、递增式最大自主等长收缩(MVIC)期间的羽状角、提踵试验以及台湾中文版下肢功能量表(LEFS-TC)问卷,对15名参与者进行评估。结果与未受伤的腿部相比,修复后的腿部在90%MVIC时显示出较低的肌束长度(平均4.4 vs. 5.0厘米)和厚度(1.7 vs. 1.9厘米)、较低的腓肠肌肌腱和腱膜刚度(174.1 vs. 375.6牛/毫米)以及更大的腓肠肌羽状角(31.2 vs. 28.9°)(所有p≤0.05)。在形态力学结果与最大提踵高度或LEFS-TC评分之间,以及肌束长度的对称比与LEFS-TC评分之间发现了相关性。解释跟腱修复后的前六个月内,参与者内侧腓肠肌的肌束长度、肌肉厚度和力学性能有所下降。这些形态力学改变表明与下肢功能水平有关,并表明修复后需要尽早对小腿肌肉进行活动。
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